Which condition is associated with intravitreal traction, severe myopia, vitreoretinal traction, age-related vitreous degeneration, and trauma as primary causes?

• A. Central retinal artery occlusion
• B. Retinal detachment due to exudation
• C. Vitreous hemorrhage
• D. Rhegmatogenous retinal detachment

Answer: (D)

The idea being tested is how a retinal detachment caused by a tear forms and why certain risk factors point to that type. Rhegmatogenous retinal detachment happens when a break or tear in the retina allows liquefied vitreous to seep underneath, separating the retina from the underlying tissue. The factors listed—intravitreal traction, severe myopia, age-related vitreous degeneration with posterior vitreous detachment, and trauma—all raise the likelihood of retinal tears. In aging, the vitreous becomes more liquefied and can pull on the retina (traction); in severe myopia the retina is stretched and thinner, making tears easier; and trauma can create a tear directly. Once a tear is present, fluid can flow through it and cause a detachment, which is the hallmark of rhegmatogenous RD.

This differs from other conditions: central retinal artery occlusion is a vascular event causing sudden vision loss without a retinal tear or detachment; exudative (serous) retinal detachment results from fluid leakage under the retina due to inflammation or neovascular issues rather than a tear; vitreous hemorrhage involves blood in the vitreous and is not driven by a retinal break.